Abstract P252: Sarcopenic Obesity is Associated With a High Burden of Cardiovascular Disease
Introduction: Sarcopenic obesity, characterized by low muscle mass in the setting of obesity, may be associated with more adverse metabolic outcomes relative to obesity alone. Studies that have examined sarcopenic obesity and cardiovascular disease are scarce.
Hypothesis: We tested the hypothesis that sarcopenic obesity is associated with an increased burden of cardiovascular disease (CVD).
Methods: We examined cross-sectional associations between sarcopenic obesity and CVD risk factors in the Framingham Heart Study Offspring and OMNI cohorts (n=1005; 46.4% women; mean age 69.8 years). Muscle mass was assessed using 24-hour urinary creatinine concentration (24h UC). We categorized participants into four groups by BMI (cut-point of 30 kg/m2) and median value of 24h UC (1069 mg/d in women and1673 mg/d in men). Participants had higher BMI and lower 24h UC were grouped into sarcopenic obesity. CVD risk factors were metabolic syndrome (METS), hypertension (HTN), type 2 diabetes (T2D), chronic kidney disease (CKD), microalbuminuria (MA), and prevalent CVD. We applied sex-specific logistic regression models to test for significance of associations. After adjustment for age, we further adjusted BMI and 24h UC to test if the association persisted beyond individual components.
Results: In women, compared with those had lower BMI and higher 24h UC, individuals with sarcopenic obesity (n=50) had higher odds of METS (OR = 5.9; 95%CI: 2.7-12.9), HTN (OR = 5.5; 95%CI: 2.2-14.1), MA (OR = 6.3; 95%CI: 1.8-22.2), and T2D (OR = 7.5; 95%CI: 3.1-18.0). The odds of T2D (OR = 2.4; 95%CI: 1.1, 5.3) and MA (OR = 4.4; 95%CI: 1.3, 15.6) in sarcopenic obesity were significant higher in contrast to obesity alone (with higher BMI and high 24h UC). After additional adjustment for BMI and 24h UC, the associations between sarcopenic obesity and MA and T2D in women remained significant in comparison with women who were neither sarcopenic nor obese. In men, sarcopenic obese individuals (n=53) had a higher odds of METS (OR = 3.1; 95%CI: 1.5-6.5), T2D (OR = 4.3; 95%CI: 1.9-9.5), and prevalent CVD (OR = 4.0; 95%CI: 1.6-10.2). Also, those with sarcopenic obesity had a higher odds of prevalent CVD (OR = 3.8; 95%CI: 1.3, 10.8) compared with the obesity group that was not statistically significant after additional adjustment for BMI and 24h UC.
Conclusions: Compared with individuals who are neither sarcopenic nor obese, sarcopenic obesity is associated with a high burden of CVD risk factors in both older women and men. Our observations suggest a synergistic relationship between muscle loss and adiposity in older adults, in particular in women at older age.
Author Disclosures: J. Ma: None. S. Hwang: None. G.M. McMahon: None. G.C. Curhan: None. R.R. McLean: None. J.M. Murabito: None. C.S. Fox: None.
- © 2015 by American Heart Association, Inc.